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HomeMy WebLinkAboutMortgage_Fish / ? STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS County Township Year O --\,St b FOR DEDUCTION FROM ASSESSED VALUATION q- c)(-) ©O n \, ,, .,�. State Form 43709(R13/10-15) ..- es `,, Prescribed by Departme of Local Gov r ent Finance INSTRUCTIONS: GO ity\_ •1 1 File Mark To be filed in person or by mail. ` 1 F filed with: Filing Dates: 1) Real Property:Must be completed a d dated in the ca/en ar year for which th eduction is sought. Must be filed or postmarked with the County Auditor or Co my Recorder of t c unty where the property is County Auditor located on or before January 5 of the immediately succeeding calendar year. County Recorder 2) Mobile/Manufactured Homes not assessed as Real Property:Must file with the County Auditor of the county where the property is located during the twelve(12)months before March 31 of each year the deduction is sought. See reverse side for additional instructions and qualifications. Applicant(owner or contract buyer-see restrictions on reverse side) Randy Lewis Fish Taxing District Key number/legal description Record number PT numbs Columbia 26-14-19-104-000.867-006 �Zo 11 Assessed value of real property as of Mortgage/Contract indebtedness unpaid as of Mortgage/Contract indebtedness unpaid as of Is the IliWan the sole assessment date,current year assessment date,current year date of application legal or equitable owner? $76,000.00 IZI Yes 0 No If no,what is his/her exact share of interest? If owned with someone other than spouse,indicate with whom If name on record is different than that of applicant,indicate below: ti •fir e.ro question:Annually Assessed Eg "eal rop 0 Annually Assessed • _.,' Mobile Home(IC 6-1.1-7) Name of mortgagee or contract seller _Evansville Teachers Federal Credit Union - DEC i 6 2020 Address of mortgagee or contract seller(number and street,dig state,and ZIP code) 4401 Theater Drive, Evansville, IN 47715 Name of assignee or other owner or holder of mortgage412A4L ±CIA4 CIBSON COUNTY AUDITOR Address of assignee(number and street,dty,state,and ZiP code) Does applicant own property in any If yes,what county? What Taxing District? Has this deducti een requested If yes,state amount of deduction other county on property for in Indiana? ❑Yes ,/❑No current year? Yes El No A person is not entitled to this deduction unless the person has a balance on the person's mortgage o con ct indebtedness that is recorded in the county recorder's office(including any home equity line of credit that is recorded in the county recorder's office)that is the basis for the deduction. COUNTY AUDITOR Deduction approved in the amount of: 20 20 20 20 20 20 20 Signature of County Auditot • County ` Daclontlit yea ro W alSill'\i t(1 SC—.1 1 9 LS04\ I/We certify under th- •enalty of perjury that the above and foregoing information is t nd correct and that the applicant is a resident of Indiana and owne ontract buyer of the aforementioned property on date application is filed. Signature nets f 'nam --------_-, Date(month,day,year) • _ 08/28/2020 Ful resident ad ress of applicant(number and street,city,state,and ZIP code) 1855 1200 E, Oakland City, IN 47660 Person authorized by duly executed Power of Attorney or by IC 6-1.1-12-0.7 Date(month,day,year) Address of authorized person (number and street,city,state,and ZIP code)